What is the GERD treatment process?

GERD treatment is based on whether your symptoms are mild, moderate, or severe. To learn more about these levels of symptoms and how they might impact your life, see What are the levels of GERD symptoms? After your doctor has determined how severe your symptoms are, he or she will work with you to develop an initial treatment plan. Both you and your doctor will determine whether this plan is right for you or whether adjustments should be made.

Like high blood pressure, GERD is considered a chronic condition, meaning that it can be controlled but not cured by medications. People who have more severe symptoms or greater damage to the esophageal tissues, or whose symptoms return as soon as medication is stopped, often need ongoing treatment to control and relieve symptoms. This type of ongoing, long-term treatment is known as maintenance treatment.

Initial treatment for mild-to-moderate GERD. The first step in treating mild-to-moderate GERD symptoms is lifestyle changes. Your doctor will recommend changes based on many factors in your everyday life that may contribute to your symptoms.

Along with these changes, your doctor may also recommend any of the following medications to use on an "as-needed" basis, which means that you can use them whenever symptoms start or before symptoms occur: antacids, alginic acid/antacids combinations, or H2 blockers. All of these medications are available over the counter.

Initial treatment for moderate-to-severe GERD.With moderate-to-severe GERD, lifestyle changes are also important. However, rather than take medication as needed, moderate-to-severe GERD is treated continuously for 6 to 12 weeks, sometimes even longer. Your doctor will select medications based on the severity of your symptoms and whether or not reflux has damaged your esophagus.

Maintenance treatment for persistent-but-mild GERD. People who require maintenance treatment may be directed to take either antacids or H2 blocker medication on a regular schedule rather than taking them "as needed." Your doctor will determine the best schedule for you. Using an H2 blocker medication and making lifestyle changes works well to control symptoms and heals about 50% of people with GERD. H2 blockers are used to prevent and relieve symptoms of heartburn and sour stomach, while antacids are best for rapid relief of symptoms and can be taken immediately after meals as well as within 1 to 3 hours of bedtime.

Maintenance treatment for persistent moderate-to-severe GERD. People who have more severe symptoms, greater damage to the esophageal tissues, or whose symptoms return as soon as medication is stopped often need ongoing treatment to control and relieve symptoms. This type of ongoing, long-term treatment is known as maintenance treatment. Maintenance treatment requires aggressive measures to block the production and release of stomach acid. The American College of Gastroenterology recommended a new approach for treating chronic GERD in 1999. This method uses proton pump inhibitors, such as Prevacid, Prilosec, Aciphex, and Protonix. They are also used when complications such as esophagitis fail to heal with regular treatment. For more information on proton pump inhibitors, see Proton Pump Inhibitors. Studies show that these medications effectively control symptoms for at least a year in more than 75% of people with GERD. They are generally taken once a day, in the morning before breakfast. However, higher doses of proton pump inhibitors may be necessary in very severe GERD or in people who don't respond to treatment.